hospice guidelines for determining prognosis, pulmonary disease

Introduction

Guidelines:

• severity of chronic lung disease, documented by
  • disabling dyspnea at rest, poorly responsive to bronchodilators
  • FEV1 of < 30% of predicted (after bronchodilator) or a decrease in FEV1 of > 40 mL/year
  • increasing visits to Emergency Department or hospitalizations
• metastatic lung cancer
  • poor performance status owing to lung cancer with no driver mutation & patients with irreversible end-organ damage
• right heart failure (cor pulmonale) due to pulmonary disease
  • documented by
    • echocardiogram
    • electrocardiogram
    • chest X-ray
    • physical signs of right heart failure
• hypoxemia at rest on supplemental oxygen
  • paO2 =< 55 mm Hg on supplemental oxygen
  • O2 saturation =< 88% on supplemental oxygen
• hypercapnia: pCO2 > 50 mm Hg
• unintentional, progressive weight loss of > 10% body weight over preceding 6 months
• resting tachycardia > 100/min

More general terms

• hospice guidelines for determining prognosis